A strategy for the care workforce

Globally, the care economy is growing as the demand for care for children and the elderly increases. We are all likely to need, provide, and/or receive some form of care in our lives but adult social care and childcare and early education 1  in England are in crisis, with many people unable to access the care services they need for themselves and their families.

Representing different parts of England’s care system, the underlying challenges facing the childcare and social care sectors are almost identical: government inaction, chronic underinvestment, a fragmented and largely privatised provider landscape, and widespread exploitation of care workers by employers enabled by weak accountability and labour market enforcement mechanisms.

However, the single greatest challenge affecting our care system is staffing - with both sectors experiencing acute recruitment and retention issues. Care work remains stubbornly low paid, with workers overwhelmingly facing poor working conditions, limited development and progression opportunities, and poor support for their health, safety and wellbeing. The workforce, overwhelmingly female, are often marginalised and silenced in issues affecting their day-to-day working lives, including the level of care, support and education they can provide.

“We’re chronically short staffed despite recruitment efforts. We don’t have the resources and materials we would like to enhance the children’s learning and development.” Nursery worker

“There are unsafe staffing levels on both the day and night shifts. Care is depressingly rushed and residents long for just those few extra minutes of social contact. But we simply don’t have the time. Staff are on their knees. Many are taking jobs in supermarkets for the same pay but far less stress.” Social care worker

New TUC analysis shows that across the UK care workers are earning below the real living wage and are significantly underpaid relative to pay across the rest of the economy.

• More than three in five (62 per cent) childcare assistants and practitioners earn less than the real living wage.
• More than three in five (61 per cent) social care workers and senior care workers earn less than the real living wage.2
• Social care workers earn only around 65 per cent of the median salary for all employees (£21,500 per annum compared to £33,000).3
• And in childcare, practitioners earn only 56 per cent of the median salary for all employees (£18,400), while childcare assistants earn 58 per cent of the median wage (£19,000).

This leaves many care workers and their families struggling to survive - more than one in four (28 per cent) children with a social care worker parent are growing up in poverty.4

“I had to use savings and cut back on spending to make sure had enough for a household shop and pay bills like rent, electric and gas. In the past l have gone without to make sure my children don't go without.” Social care worker

While central government is the predominant source of public funding for care the organisation of care is devolved to the four nations, which has led to significant divergence in how care services are run and funded. Local authorities are responsible for ensuring sufficient provision of social care and childcare in their area.

Currently, there is no overarching national workforce strategic framework and associated funding in England. The failure of successive governments to engage in strategic workforce planning has meant staff numbers have failed to keep pace with the increased demand for social care and childcare – a challenge that will only grow in the future.

• New TUC analysis of Coram Family and Childcare trust survey data found that 97 of 102 (95 per cent) English local authorities that responded to the survey said they were having difficulty recruiting staff with the right skills and qualifications – and 81 (80 per cent) said it was “very difficult”.
• In social care in England, there are currently 152,000 vacancies, equivalent to a 9.9 per cent vacancy rate. 5

To help fill this gap, the TUC is proposing a new care workforce strategy for England, developed with trade unions and informed by the voice and experiences of care workers. We set out the critical building blocks to ensure care workers are valued and supported, as a key means of addressing the current staffing crisis and improving access to and quality of social and childcare services.6

Therefore, the core elements as set out in this workforce strategy should be integrated into government policy at the highest levels and led by relevant departments overseeing childcare and social care in England – currently the Department for Education and the Department for Health and Social Care respectively in England. We propose that the final strategy is agreed through National Partnership Forums in social care and childcare, with full participation of workers and their unions.

We propose four key focus areas for the national care workforce strategy:

• Worker voices heard and valued including through sectoral collective bargaining arrangements and through the creation of National Partnership Forums in social care and childcare.
• Decent pay and conditions for all care workers through a collectively bargained sectoral agreement on fair pay and decent working conditions, a new sectoral minimum wage of £15 per hour, sick pay, secure contracts and full payment for all time worked, as well as access to efficient labour market enforcement mechanisms.
• Skills, training, and progression pathways with nationally negotiated training frameworks to ensure consistency and quality. These should be aligned with national pay structures to make sure staff are fairly renumerated and can progress as they acquire new skills and knowledge. Training must be accredited and qualifications recognised and transferrable to new employers.
• Protect health, safety, and wellbeing including ensuring that staffing levels are based on care and education needs and not arbitrary ratios. And a zero-tolerance approach to workplace abuse with comprehensive safeguarding and support, notably for staff who may be at increased risk of experiencing abuse and harassment including Black and migrant workers.   

To deliver this strategy the TUC is calling for government to take the following enabling actions:

• Provide adequate, long-term treasury funding to deliver the strategy including off-setting 13 years of real terms cuts to local authority budgets and establishing a future funding pathway that will enable local authorities to meet demand and deliver good pay and conditions for the care workforce including a £15 wage floor.
• Support local authorities to move towards public provision of social care and childcare wherever possible and as soon as possible. Where a decision is made to outsource delivery of care services, public funding must come with conditions to ensure that public contracts deliver decent employment standards and high quality care.
• Develop in-depth data and insight to understand current workforce needs in both social care and childcare, predict future trends and support transparency.
• Increase attention given to care services in contingency planning exercises, so that the care workforce role, and requirements such as staffing levels, are better understood before any future pandemic or other disaster.
• Ensure worker voice is central to the implementation of technology used to plan, deliver and monitor care services, including digital technology and AI to ensure that care workers are aware of how technology is being used and for what purpose and that workers are not exploited or discriminated against.

• 1 Hereafter referred to as social care and childcare, respectively.
• 2 Real living wage analysis is based on Labour Force Survey Q1 2023, and the Living Wage Foundation’s Real Living Wage of £10.90 per hour. The analysis has been done at national level using the £10.90, and therefore does not take into consideration the higher Real Living Wage in London. As the analysis was done based on Q1 2023, it does not take into the account the planned pay rise in Wales, which came into effect in June: https://www.gov.wales/social-care-workers-in-wales-to-receive-real-living-wage-uplift 
• 3 Comparisons to median salary are full-time salaries and based on the 2022 Annual Survey of Hours and Earnings.
• 4 TUC (2022) 1 in 4 children with care worker parents are growing up in poverty | TUC 
• 5 Skills For Care (2023) The size and structure of the adult social care sector and workforce in England 
• 6 This care workforce strategy builds on TUC’s recent New Deal for Social Care and a New Deal for the Childcare Sector proposals.